Can the delta neutrophil ındex be used as a preliminary biomarker ın the evaluation of periodontal disease: a pilot study

Abstract

Can the delta neutrophil ındex be used as a preliminary biomarker ın the evaluation of periodontal disease: a pilot study Objective: Tissue destruction in periodontal diseases is related to inflammatory mediators in the host. However, it is unknown whether a relationship between delta neutrophil index (DNI) and neutrophil-lymphocyte ratio (NLR) in Stage 3 Grade A patients occurs. This cross-sectional study aimed to investigate the relationship between periodontal disease and DNI and NLR. Methodology: The study included 74 systemically healthy, nonsmoking adults separated into 3 groups. Group 1: 26 subjects with good periodontal health, Group 2: 26 subjects with gingivitis, and Group 3: 22 subjects with Stage 3 Grade A periodontitis. After determining which group the patient will be included in, a clinical periodontal examination was made of each patient and pocket depth (PD), clinical attachment level (CAL), gingival index (GI), bleeding on probing (BOP) and plaque index (PI) parameters were measured. Venous blood samples were taken and examined with an automatic hematology analyzer for DNI, immature granulocytes (IG), NLR, C-reactive protein (CRP), procalcitonin, neutrophil count and lymphocyte count. Results: DNI, IG, CRP, and neutrophil count were observed to be highest in Group 3, followed by Group 2, and the difference between the groups in these parameters was determined to be statistically significant (p<0.001, p<0.001, p=0.046, p=0.016). DNI, IG, CRP and neutrophil count were observed to be positively correlated with periodontal parameters. Conclusion:The findings of this study support the role of DNI as a new biomarker for periodontal diseases. DNI may better reflect the systemic level of stage 3 grade A periodontitis than traditional inflammatory markers.

Blood Cell Count Inflammatory Markers as Prognostic Indicators of Periodontitis: A Systematic Review and Meta-Analysis

“…Regarding the selection section of the NOS scale, all the studies used pre-defined, transparent criteria to identify the presence of the disease (chronic periodontitis or aggressive periodontitis) and controls; thus, the case and control definitions were adequate. Nevertheless, the authors of the studies used different criteria to identify the disease according to official classifications (Periodontal Disease Classification, American Association of Periodontology 1999-three studies [ 23 , 25 , 28 ]; Classification of Periodontal and Peri-Implant Diseases and Conditions 2017-four studies [ 1 , 2 , 26 , 27 ]; Center of Disease Control and Prevention, American Academy of Periodontology Periodontal Disease Classification CDC/AAP-one study [ 29 ]), or no specified classification [ 7 , 24 ]. Only two studies (20%) out of ten had clear representativeness of the cases [ 23 , 28 ].…”

“…For the other six, it might be difficult to assess if the selection of controls was correct. Half of the studies enrolled subjects from the department of periodontology [ 1 , 2 , 7 , 23 , 26 ]; the other studies enrolled subjects from the internal medicine [ 28 ] or cardiology departments [ 24 ], or from an electrical company [ 29 ], and in two studies, the population was not stated [ 25 , 27 ].…”

“…The authors of the chosen studies from our systematic review and meta-analysis evaluated the smoking status in different ways: the authors Acharya AB et al [ 7 ] and Lu RF et al [ 25 ] did not discuss smoking. Çetin Özdemir E et al [ 1 ], Mishra S et al [ 26 ], and Ustaoglu G et al [ 2 ] studied non-smoking subjects; thus smoking was excluded as a confounder. In the study of Dogan B et al [ 24 ], almost the entire population consisted of non-smokers, and therefore, the results were interpreted as independent of the effects of smoking.…”

“…Periodontitis represents a group of chronic diseases that affect the supporting tissues of the teeth and are characterized by the destruction of periodontal tissues, the alveolar bone, and the supporting tissues of teeth. Inflammatory cells cause an immune response in the periodontal tissues [ 1 ]. The inflammatory mediators from the periodontal tissues can activate the immune system and initiate a systemic acute phase response [ 2 ].…”

“…In addition, many chronic diseases are linked to periodontitis, including cardiovascular disease, diabetes, cerebrovascular disease, neurodegenerative disease, and cancer [ 3 ]. Analyzing systemic circulatory markers, such as neutrophils [ 4 , 5 ], the neutrophil to lymphocyte ratio (NLR) [ 1 ], platelets [ 6 ], the platelet to leukocyte ratio (PLR) [ 7 ], and erythrocyte counts [ 8 ], could offer relevant data regarding systemic and periodontal infection.…”